Patient understanding, detection, and experience of COPD exacerbations: An observationa, interview-based study

R. Kessler, E. Stahl, C. Vogelmeier, John Andrew Francis Haughney, E. Trudeau, C. -. G. Lofdahl, M. Partridge

Research output: Contribution to journalArticle

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Abstract

Study objectives: This study was conducted to gain insight into patients' comprehension, recognition, and experience of exacerbations of COPD, and to explore the patient burden associated with these events.

Design: A qualitative, multinational, cross-sectional, interview-based study.

Setting: Patients' homes.

Patients: Patients (n = 125) with predominantly moderate-to-very severe COPD (age >= 50 years; with two or more exacerbations during the previous year).

Interventions: Patients underwent a 1-h face-to-face interview with a trained interviewer.

Measurements and results: During the preceding year, patients experienced a mean +/- SD of 4.6 +/- 5.4 exacerbations, after which 19.2% (n = 24) believed they had not fully recovered. Although commonly used by physicians, only 1.6% (n = 2) of patients understood the term exacerbation, preferring to use simpler terms, such as chest infection (16.0%; n = 20) or crisis (16.0%; n = 20) instead. Approximately two thirds of patients stated that they were aware of when an exacerbation was imminent and, in most cases, patients recounted that symptoms were consistent from one exacerbation to another. Some patients (32.8%; n = 41), however, reported no recognizable warning signs. At the onset of an exacerbation, 32.8% of patients (n = 41) stated that they reacted by self-administering their medication. Some patients spontaneously mentioned a fear of dying (12.0%; n = 15) or suffocating (9.6%; n = 12) during exacerbations, and effects on activities, mood, and personal/family relationships were frequently reported. Physicians tended to underestimate the psychological impact of exacerbations compared with patient reports.

Conclusions: This study shows that patients with frequent exacerbations have a poor understanding of the term exacerbation. Patient recollections suggest that exacerbation profiles vary enormously between patients but that symptoms/warning signs are fairly consistent within individuals, and are generally recognizable. Exacerbations appear to have a significant impact on patient well-being, including psychological well-being, and this may be underestimated by physicians.

Original languageEnglish
Pages (from-to)133-142
Number of pages9
JournalChest
Volume130
DOIs
Publication statusPublished - Jul 2006

Keywords

  • burden
  • COPD
  • exacerbation
  • patient's perspective
  • OBSTRUCTIVE PULMONARY-DISEASE
  • QUALITY-OF-LIFE
  • CHRONIC-BRONCHITIS
  • HEALTH-STATUS
  • LUNG-FUNCTION
  • TIME-COURSE
  • ASTHMA
  • IMPACT
  • HOSPITALIZATION
  • SALMETEROL

Cite this

Patient understanding, detection, and experience of COPD exacerbations: An observationa, interview-based study. / Kessler, R.; Stahl, E.; Vogelmeier, C.; Haughney, John Andrew Francis; Trudeau, E.; Lofdahl, C. -. G.; Partridge, M.

In: Chest, Vol. 130, 07.2006, p. 133-142.

Research output: Contribution to journalArticle

Kessler, R. ; Stahl, E. ; Vogelmeier, C. ; Haughney, John Andrew Francis ; Trudeau, E. ; Lofdahl, C. -. G. ; Partridge, M. / Patient understanding, detection, and experience of COPD exacerbations: An observationa, interview-based study. In: Chest. 2006 ; Vol. 130. pp. 133-142.
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abstract = "Study objectives: This study was conducted to gain insight into patients' comprehension, recognition, and experience of exacerbations of COPD, and to explore the patient burden associated with these events.Design: A qualitative, multinational, cross-sectional, interview-based study.Setting: Patients' homes.Patients: Patients (n = 125) with predominantly moderate-to-very severe COPD (age >= 50 years; with two or more exacerbations during the previous year).Interventions: Patients underwent a 1-h face-to-face interview with a trained interviewer.Measurements and results: During the preceding year, patients experienced a mean +/- SD of 4.6 +/- 5.4 exacerbations, after which 19.2{\%} (n = 24) believed they had not fully recovered. Although commonly used by physicians, only 1.6{\%} (n = 2) of patients understood the term exacerbation, preferring to use simpler terms, such as chest infection (16.0{\%}; n = 20) or crisis (16.0{\%}; n = 20) instead. Approximately two thirds of patients stated that they were aware of when an exacerbation was imminent and, in most cases, patients recounted that symptoms were consistent from one exacerbation to another. Some patients (32.8{\%}; n = 41), however, reported no recognizable warning signs. At the onset of an exacerbation, 32.8{\%} of patients (n = 41) stated that they reacted by self-administering their medication. Some patients spontaneously mentioned a fear of dying (12.0{\%}; n = 15) or suffocating (9.6{\%}; n = 12) during exacerbations, and effects on activities, mood, and personal/family relationships were frequently reported. Physicians tended to underestimate the psychological impact of exacerbations compared with patient reports.Conclusions: This study shows that patients with frequent exacerbations have a poor understanding of the term exacerbation. Patient recollections suggest that exacerbation profiles vary enormously between patients but that symptoms/warning signs are fairly consistent within individuals, and are generally recognizable. Exacerbations appear to have a significant impact on patient well-being, including psychological well-being, and this may be underestimated by physicians.",
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AU - Kessler, R.

AU - Stahl, E.

AU - Vogelmeier, C.

AU - Haughney, John Andrew Francis

AU - Trudeau, E.

AU - Lofdahl, C. -. G.

AU - Partridge, M.

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N2 - Study objectives: This study was conducted to gain insight into patients' comprehension, recognition, and experience of exacerbations of COPD, and to explore the patient burden associated with these events.Design: A qualitative, multinational, cross-sectional, interview-based study.Setting: Patients' homes.Patients: Patients (n = 125) with predominantly moderate-to-very severe COPD (age >= 50 years; with two or more exacerbations during the previous year).Interventions: Patients underwent a 1-h face-to-face interview with a trained interviewer.Measurements and results: During the preceding year, patients experienced a mean +/- SD of 4.6 +/- 5.4 exacerbations, after which 19.2% (n = 24) believed they had not fully recovered. Although commonly used by physicians, only 1.6% (n = 2) of patients understood the term exacerbation, preferring to use simpler terms, such as chest infection (16.0%; n = 20) or crisis (16.0%; n = 20) instead. Approximately two thirds of patients stated that they were aware of when an exacerbation was imminent and, in most cases, patients recounted that symptoms were consistent from one exacerbation to another. Some patients (32.8%; n = 41), however, reported no recognizable warning signs. At the onset of an exacerbation, 32.8% of patients (n = 41) stated that they reacted by self-administering their medication. Some patients spontaneously mentioned a fear of dying (12.0%; n = 15) or suffocating (9.6%; n = 12) during exacerbations, and effects on activities, mood, and personal/family relationships were frequently reported. Physicians tended to underestimate the psychological impact of exacerbations compared with patient reports.Conclusions: This study shows that patients with frequent exacerbations have a poor understanding of the term exacerbation. Patient recollections suggest that exacerbation profiles vary enormously between patients but that symptoms/warning signs are fairly consistent within individuals, and are generally recognizable. Exacerbations appear to have a significant impact on patient well-being, including psychological well-being, and this may be underestimated by physicians.

AB - Study objectives: This study was conducted to gain insight into patients' comprehension, recognition, and experience of exacerbations of COPD, and to explore the patient burden associated with these events.Design: A qualitative, multinational, cross-sectional, interview-based study.Setting: Patients' homes.Patients: Patients (n = 125) with predominantly moderate-to-very severe COPD (age >= 50 years; with two or more exacerbations during the previous year).Interventions: Patients underwent a 1-h face-to-face interview with a trained interviewer.Measurements and results: During the preceding year, patients experienced a mean +/- SD of 4.6 +/- 5.4 exacerbations, after which 19.2% (n = 24) believed they had not fully recovered. Although commonly used by physicians, only 1.6% (n = 2) of patients understood the term exacerbation, preferring to use simpler terms, such as chest infection (16.0%; n = 20) or crisis (16.0%; n = 20) instead. Approximately two thirds of patients stated that they were aware of when an exacerbation was imminent and, in most cases, patients recounted that symptoms were consistent from one exacerbation to another. Some patients (32.8%; n = 41), however, reported no recognizable warning signs. At the onset of an exacerbation, 32.8% of patients (n = 41) stated that they reacted by self-administering their medication. Some patients spontaneously mentioned a fear of dying (12.0%; n = 15) or suffocating (9.6%; n = 12) during exacerbations, and effects on activities, mood, and personal/family relationships were frequently reported. Physicians tended to underestimate the psychological impact of exacerbations compared with patient reports.Conclusions: This study shows that patients with frequent exacerbations have a poor understanding of the term exacerbation. Patient recollections suggest that exacerbation profiles vary enormously between patients but that symptoms/warning signs are fairly consistent within individuals, and are generally recognizable. Exacerbations appear to have a significant impact on patient well-being, including psychological well-being, and this may be underestimated by physicians.

KW - burden

KW - COPD

KW - exacerbation

KW - patient's perspective

KW - OBSTRUCTIVE PULMONARY-DISEASE

KW - QUALITY-OF-LIFE

KW - CHRONIC-BRONCHITIS

KW - HEALTH-STATUS

KW - LUNG-FUNCTION

KW - TIME-COURSE

KW - ASTHMA

KW - IMPACT

KW - HOSPITALIZATION

KW - SALMETEROL

U2 - 10.1378/chest.130.1.133

DO - 10.1378/chest.130.1.133

M3 - Article

VL - 130

SP - 133

EP - 142

JO - Chest

JF - Chest

SN - 0012-3692

ER -